Introducing Peer Support to Arnold Lodge Medium Secure Mental Health Hospital Leicester

Arnold Lodge was first established in 1983. It’s one of the first medium secure services. It provides a service to over 100 inpatients on seven wards across the three care streams for both men and women.

Nottinghamshire Healthcare NHS Foundation Trust (Nottshc) has been employing peer support workers since 2010. Peer support worker roles have focussed mainly in our Adult Mental Health services, including inpatient wards, community teams and Recovery Colleges. Peer support workers offer one-to-one and group support based on shared experience, empathy and recovery focused approaches. They receive training which focuses on the eight core principles of peer support (developed by ImROC) as well as the development of active listening skills, personal and professional boundaries, and reflective practice. The training also includes a 30-hour work placement which students undertake within a clinical area.

Our Trust employs around 60 peer support workers across their services, but have not yet employed peer workers within forensic services, although there is support among staff and patients for doing so. It has been argued that peer support is particularly relevant to the secure setting and there is great potential for secure services to actively facilitate peer support (Together, 2014). In addition, there is increased potential for more stable, long-term relationships between peer support workers and those they support than in acute or community settings.

Staff members at Arnold Lodge have long been passionate about peer support and have been working on developing their first peer support worker role. Time has been spent thinking about where this role would be best placed to offer support and complement existing services. In addition, consideration has been given to how a peer support worker could be best supported to develop in their role and manage their own wellbeing.

Drawing on the best practice that has been established within mainstream mental health settings, it was decided that the peer support worker would be based within the Occupational Therapy department, giving them the opportunity to contribute to different groups and offer one-to-one work with the support of the Occupational Therapy team.

This positioning also allows a peer support worker a significant degree of autonomy to develop their role based on their own strengths, whilst also being able to be involved in activities alongside other colleagues. Arnold Lodge has an established Recovery College and an extensive therapeutic programme that includes a ‘Making Sense of Voices’ groups. The addition of a peer support worker could create an environment of mutual sharing to this and other therapeutic approaches.

The peer support worker will receive training and support from colleagues in therapy and psychology services at Arnold Lodge and from the peer support development team which is located within the Trust’s Learning and Organisational Development Department. It is common practice for all peer support workers in Nottshc to receive supervision from their team leader as well as ‘peer’ supervision from a member of the peer support development team. This provides opportunities for peer workers to reflect on their growing skills and any difficulties they face in the role. Personal wellbeing is a common feature of supervision for all staff and peer workers are no different. They will be encouraged to consider their own wellbeing at work plan and share this with their supervisors within supervision. Peer workers also attend quarterly peer support development days; a chance for them to reunite with other peer workers from across Nottshc, share their experiences and refresh their skills, as well as hear about developments in peer support across the country.

Because this is the first peer worker role within forensic services in the Trust, it will be evaluated as it evolves. There is potential for the peer worker to increase their hours if the role is successful and it is hoped that this role will pave the way for other peer workers in the future, both in Arnold Lodge and in other forensic services throughout the Trust.

Emma Watson, Peer Support Development Lead, Dr Patrick Sims, Head of Therapies and Fiona Evriviades, Occupational Therapy Manager, Arnold Lodge

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